Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study

Clayton Blehm,1 Richard Potvin2 1Gainesville Eye Associates, Gainesville, GA, 2Science in Vision, Akron, NY, USA Purpose: The aim of this study was to assess the effectiveness of the Verion-LenSx guided arcuate incision technique to reduce refractive astigmatism in a pseudophakic population. Patie...

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Autores principales:	Blehm C, Potvin R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Verion LenSx cylinder cataract surgery corneal arcuate incisions astigmatism Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/debba05d63bb4052a5561326338a7165
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spelling	oai:doaj.org-article:debba05d63bb4052a5561326338a71652021-12-02T02:17:38ZPseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study1177-5483https://doaj.org/article/debba05d63bb4052a5561326338a71652017-01-01T00:00:00Zhttps://www.dovepress.com/pseudophakic-astigmatism-reduction-with-femtosecond-laser-assisted-cor-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Clayton Blehm,1 Richard Potvin2 1Gainesville Eye Associates, Gainesville, GA, 2Science in Vision, Akron, NY, USA Purpose: The aim of this study was to assess the effectiveness of the Verion-LenSx guided arcuate incision technique to reduce refractive astigmatism in a pseudophakic population. Patients and methods: A prospective single-arm study was conducted in which one or both eyes of subjects required reduction of 1.0–2.0 D of refractive astigmatism after previous cataract surgery or refractive lens exchange. The surgeon used the refractive cylinder in the eye and the Woodcock astigmatism nomogram for preoperative planning, while the LenSx femtosecond laser with the Verion Image Guided System was used to create all arcuate incisions. The primary outcome measure was the uncorrected monocular distance visual acuity (UCVA). Secondary outcome measures included the change in corneal astigmatism, the change in refractive astigmatism, the best-corrected visual acuity and spectacle independence at distance from preoperative stage to 1 month and 2 months postoperatively. Results: Twenty-eight eyes of 18 subjects were treated. The best-corrected visual acuity at the 2-month postoperative (PO) stage was not statistically significantly different from the preoperative visual acuity (0.02 logarithm of the minimum angle of resolution [logMAR] in both cases, P>0.05). Uncorrected visual acuity was statistically significantly better at the 2-month PO stage relative to the preoperative value (0.14 versus 0.34 logMAR, P<0.01). The mean change in refractive cylinder from the preoperative stage to the 2-month PO stage was 1.0 D. At the 2-month PO stage, two-thirds of the subjects (12/18) reported that they did not use glasses for distance vision and that their spectacle use for distance vision at 2 months was “lower” or “much lower” than the preoperative stage; in 71% of eyes (20/28), the residual refractive cylinder was ≤0.50 D. Vector changes in keratometric astigmatism were weakly associated with changes in refractive cylinder. Conclusion: Arcuate incisions made with a femtosecond laser to treat moderate levels of residual refractive astigmatism after previous cataract surgery may reduce dependence on spectacles for distance vision. Keywords: Verion, LenSx, cylinder, cataract surgery, visual acuity, spectacleBlehm CPotvin RDove Medical PressarticleVerionLenSxcylindercataract surgerycorneal arcuate incisionsastigmatismOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 201-207 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Verion LenSx cylinder cataract surgery corneal arcuate incisions astigmatism Ophthalmology RE1-994
spellingShingle	Verion LenSx cylinder cataract surgery corneal arcuate incisions astigmatism Ophthalmology RE1-994 Blehm C Potvin R Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
description	Clayton Blehm,1 Richard Potvin2 1Gainesville Eye Associates, Gainesville, GA, 2Science in Vision, Akron, NY, USA Purpose: The aim of this study was to assess the effectiveness of the Verion-LenSx guided arcuate incision technique to reduce refractive astigmatism in a pseudophakic population. Patients and methods: A prospective single-arm study was conducted in which one or both eyes of subjects required reduction of 1.0–2.0 D of refractive astigmatism after previous cataract surgery or refractive lens exchange. The surgeon used the refractive cylinder in the eye and the Woodcock astigmatism nomogram for preoperative planning, while the LenSx femtosecond laser with the Verion Image Guided System was used to create all arcuate incisions. The primary outcome measure was the uncorrected monocular distance visual acuity (UCVA). Secondary outcome measures included the change in corneal astigmatism, the change in refractive astigmatism, the best-corrected visual acuity and spectacle independence at distance from preoperative stage to 1 month and 2 months postoperatively. Results: Twenty-eight eyes of 18 subjects were treated. The best-corrected visual acuity at the 2-month postoperative (PO) stage was not statistically significantly different from the preoperative visual acuity (0.02 logarithm of the minimum angle of resolution [logMAR] in both cases, P>0.05). Uncorrected visual acuity was statistically significantly better at the 2-month PO stage relative to the preoperative value (0.14 versus 0.34 logMAR, P<0.01). The mean change in refractive cylinder from the preoperative stage to the 2-month PO stage was 1.0 D. At the 2-month PO stage, two-thirds of the subjects (12/18) reported that they did not use glasses for distance vision and that their spectacle use for distance vision at 2 months was “lower” or “much lower” than the preoperative stage; in 71% of eyes (20/28), the residual refractive cylinder was ≤0.50 D. Vector changes in keratometric astigmatism were weakly associated with changes in refractive cylinder. Conclusion: Arcuate incisions made with a femtosecond laser to treat moderate levels of residual refractive astigmatism after previous cataract surgery may reduce dependence on spectacles for distance vision. Keywords: Verion, LenSx, cylinder, cataract surgery, visual acuity, spectacle
format	article
author	Blehm C Potvin R
author_facet	Blehm C Potvin R
author_sort	Blehm C
title	Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
title_short	Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
title_full	Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
title_fullStr	Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
title_full_unstemmed	Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
title_sort	pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/debba05d63bb4052a5561326338a7165
work_keys_str_mv	AT blehmc pseudophakicastigmatismreductionwithfemtosecondlaserassistedcornealarcuateincisionsapilotstudy AT potvinr pseudophakicastigmatismreductionwithfemtosecondlaserassistedcornealarcuateincisionsapilotstudy
_version_	1718402624284262400

Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study

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